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1295795755
BRIAN GAMBORG
LAKE CHARLES, LA
NPI
1295795755
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: LA 023359)
Enumeration Date
2006-03-27
Last Update Date
2022-04-29
Business Address
BRIAN GAMBORG
1525 OAK PARK BLVD
LAKE CHARLES, LA 70601-8849
Phone number: 337-494-6767
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Mailing Address
BRIAN GAMBORG
PO BOX 123453 DEPT 3453
DALLAS, TX 75312-3453
Phone number: 337-494-2921
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